Effects of an occupational therapy program on functional outcomes in older stroke patients

During the last decade, occupational therapy has gained increasing importance as component of the rehabilitation programs in disabled patients.

To evaluate the efficacy of occupational therapy programs in patients with a recent stroke.

We selected all patients with a primary diagnosis of ischemic stroke (n = 50) consecutively admitted to the two post-acute Geriatric Rehabilitation Units (CEMI 2 and 3) of the 'A. Gemelli' Hospital--Catholic University of Sacred Heart, Rome, Italy. Patients in the unit CEMI 3 (intervention group) received 8 weeks (3 h per day) of a combined rehabilitation program based on occupational therapy and physiotherapy. Patients admitted to the control unit (CEMI 2) received no input from the occupational therapist.

Overall, patients had a moderate-to-severe impairment in basic activities of daily living; the mean ADL score was 30.8 (SD +/- 7.8) in the intervention group and 30.7 (SD +/- 6.1) in the control group (p = 0.9). After 8 weeks of treatment the mean ADL score in the intervention group was 13.2 (SD +/- 9.9) compared to 20.3 (SD +/- 11.5) in the control group (p = 0.02). Differences between the intervention and control groups were statistically significant for transfers (+2.8 vs. +1.6 points on the ADL scale, p = 0.006), locomotion (+3.4 vs. +1.7 points on the ADL scale, p = 0.01), dressing (+3.0 vs. +1.8 points on the ADL scale, p = 0.01) and self-care (+3.4 vs. +1.8 points on the ADL scale, p = 0.005).

Our results show that patients with stroke who received occupational therapy had a greater level of independence in activities of daily living over a period of 8 weeks than patients who did not.